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• CITY OF ORONO * z 0 1 5 — 0 0 0 s 1 * <br /> _ 2750 KELLEY PARKWAY DATE ISSUED: OU23/2015 <br /> ORONO, MN 55356— <br /> 952) 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 100 CREEK RIDGE PASS <br /> PIN : 03-117-23-12-0016 <br /> LEGAL DESC : CREEKSIDE IN ORONO <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 1,400,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 1,400,000.00 <br /> TYPE OF PERM[T THIS PAYMENT IS FOR: NEW HOME <br /> PERM['C#THIS PRE-PAYMENT IS TIED TO:2015-00080 <br /> APPLICANT ADVANCED PLAN REVIEW 5,157.48 <br /> TOTAL 5,157.48 <br /> BESIKOF,JUSTIN&MEIRA Payment(s) <br /> 16103 CROSBY COVE CHECK 1022 5,157.48 <br /> WAYZATA, MN 55391- <br /> OWNER City ot Orur�u <br /> 2750 Kelley_Parkw�y �52_�49-460i1 <br /> Or�no MN 55356 <br /> BESIKOF,JUSTIN& MEIRA <br /> 16103 CROSBY COVE Rer,�ipt Nn: 3.U12653 Jan 23, 2015 <br /> WAYZATA, MN 55391- <br /> Just.n & Meira Besikuf <br /> Previous Balance: •�� <br /> Permits 5,15j.4� <br /> AGREEMENT AND SWORN STATEMENT 21�-U0081 l0U Creek Ridge <br /> Pass <br /> The work for which this permit is issued shall be performed according to 101-34410 <br /> the approved plans and specifications,applicable City approvals,and the Plan Cher.k/Slte Exam Fees <br /> S[ate Building Code. This permit is for only the work described and does 5,157.48 <br /> not grant permission for additional or related work which requires separate �Uta1: ________ _____ <br /> permits. All provisions of laws and ordinances governing this type of work [;r1ECk <br /> shall be compied with whether or not specified herein.This permit will Check No: 1072 ',�5�.44 <br /> expire and become null and void if construction authorized is not �'aY':�r ; <br /> commenced within 180 days of the date of issuance,or if construction is <br /> . , „ ,, ,__:�.�.c <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � ��,}/ -- <br /> � ��;'� ����� � j `�_� 1�(f (, �� �� ��'d� �C�_� i � �� �� ( �, — <br /> Applicant ermit e Signature Date Issued By Signature Date <br />